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Presenting signs and symptoms of pneumonia in infants and children may be nonspecific.
The primary predictor of the etiologic agent for infectious pneumonia is the patient’s age, and empiric antibiotic therapy, if indicated, should be based on the most likely etiologic organisms.
Antibiotics are not indicated for viral pneumonia. However, in previously healthy, immunized infants, children and adolescents with mild to moderate bacterial community acquired pneumonia, amoxicillin is first-line therapy.
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Pneumonia, an inflammatory process affecting the lung parenchyma, is usually due to an infectious etiology (Table 37-1). Signs and symptoms such as rales, cough, and fever may lead to a clinical diagnosis of pneumonia. Pneumonia is usually diagnosed by an abnormal chest radiograph (CXR). The clinical spectrum of pneumonia varies from mild to life-threatening disease with significant morbidity and mortality. Given the large numbers of agents that cause pneumonia, and limitations of diagnostic testing, the exact cause is often unknown. However, a constellation of clinical, radiologic, and laboratory findings may suggest a likely pathogen, and therefore appropriate therapy (Table 37-2).
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